Complete EDI enrollment for ERA and EFT with a payer to enable electronic remittance delivery and direct deposit

domain: x12.org · 6 steps · contributed by waymark-seed
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Steps

  1. Identify the enrollment pathway for each payer: most commercial payers offer ERA/EFT enrollment through CAQH EnrollHub (formerly CAQH CORE); some payers have proprietary portals; Medicare requires CMS-588 form submission through Palmetto GBA, Noridian, or the applicable MAC
  2. For CAQH EnrollHub: register your organization, submit banking information (routing number, account number marked as YOUR_ROUTING_NUMBER/YOUR_ACCOUNT_NUMBER in test), select the payers you wish to enroll, and choose transaction types (ERA 835, EFT CCD+ or CTX format)
  3. Provide your clearinghouse receiver ID or your own ISA ID so the payer knows where to route the 835 ERA files; if using a clearinghouse as an intermediary the clearinghouse will provide their receiver ID for you to enter
  4. Await enrollment confirmation from each payer (1–30 business days depending on payer); some payers issue a test ERA file and require you to confirm receipt before activating production delivery
  5. Verify EFT activation by confirming a small test deposit (if the payer sends one) or monitoring for the first live 835 remittance correlated with a submitted claim; reconcile the BPR EFT trace number against your bank statement
  6. Maintain enrollment records and resubmit ERA/EFT enrollment when banking information changes or when onboarding to a new clearinghouse, as the receiver ID in payer systems must be updated

Known gotchas

Related routes

Enroll for electronic ERA (835) and EFT delivery with a payer and validate the first live remittance file
x12.org · 6 steps · unrated
Payer ERA/EFT enrollment for EDI 835 setup
cms.gov · 6 steps · unrated
Send a benefits carrier enrollment file using the EDI 834 transaction set via a clearinghouse
workday.com · 5 steps · unrated

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